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Health to the Care

Kash has a great post comparing America's health care with those of other developed nations. As you all know by now, our system's report card lands us in the remedial classes. There's virtually no metric that, when compared to other wealthy nations, we don't languish on the tail-end of. Kevin follows Kash with another great post comparing our house-of-horrors system with the far-superior French model. France is the way to go if you want to sidestep the (way overblown) pitfalls of Canadia Care (as I like to call it) and the total mess that is Britain. But it also shows why we're having such trouble in the health care debate. We've lost all our examples. The right took hold Canada and, despite the fact that their system scores far better than ours and spends much less doing it, painted a nightmarish and wholly false scenario of elderly refugees streaming to Vermont for hip surgery. O'Reilly and friends have spent the last few years striking the word France off the map and crayoning in "UnAmerican Land", so we can't quite laud France. So what have we got? Sweden? Tiny and homogenous. Britain? Uh, best not to mention them. Germany? Yeah, but not really a single-payer system. And so forth.

It's not that folks don't like the idea of government-run health care so much as we've let the prominent examples of how it works get turned against us. So now we mention single-payer and the return volley is full of sick Canadians being strechered into Detroit and uppity Frenchmen in stinktastic waiting rooms. Making single-payer safe for public discussion will require some rehabilitation of its international incarnations. Invoking France's doctor choice and lower spending is a good way to begin, but we're really going to have to tie France to Canada (as they're the most frequent counterexample), make the case for why both are better than what we've got, and then wonder why Republicans don't think American terrifictude can improve on these versions. Because that's really the disconnect here. Other countries aren't perfect, but we're much worse. The argument should then be that we can better the improvement they represent. We are, after all, America; shouldn't we be able to teach the world how health care's done?

As a final point, Kevin's post touches one of the deep fissures in the health care debate. 43,000,000 Americans lack health insurance. That's 70% of Bush's total vote. Now, a bunch of them are children, but even so, that's an enormous constituency. Were they voting as any sort of a bloc, which you'd expect a group tied to the enactment of a certain policy to do, they'd own the political system. But since they're mostly poor and disproportionately young, nobody listens. Add that to the fact that most folks with insurance are reasonably happy with their plans and you've got an overwhelmingly urgent issue perfectly primed to be ignored. And so it is ignored. Later today I'm going to talk a bit more about how vision really means simplicity, and matching the 30-word Republican platform merely means talking about only thirty words of our platform. At least fifteen of those words better be the health care, stupid, because if we can demonstrate that remaking the American system is our primary domestic goal, we'll have both a radical vision and a couple percentage points of new voters ready to tout. As Josh Marshall would say, more later.

Update:See? Now that's the problem with this blog thingie, you spend two weeks talking about nothing but health care plans and, seven days later, no one remembers you ever mentioned them at all. Anyway, root around here if you want some policy to go with your politics.

Update the Sequel: Brad Plumer has more on the structural forces that make the press report on other countries as if they lock their sick up in a room and poke them with sticks. His points are right and, to be clear, I don't mean to say it's all been a massive disinformation campaign by the right. Republicans don't like how things work in other countries so they're wholly justified in emphasizing long waits, less choice, simpler technology, and every other nasty anecdote they can dig up. It's the press's job to cut through that, and it's yet another place where they've failed. But the fact stands that Democrats haven't been assertive on our end of the debate either, and we've spent little-to-no time emphasizing other methods of health care delivery. That's largely because the 1994 debacle traumatized us, but it's time accept our pain and move on.

About the Author

Ezra Klein is a staff reporter at The Washington Post. You can read his blogging here. His work has appeared in the LA Times, The Guardian, The Washington Monthly, The New Republic, Slate, and The Columbia Journalism Review. He's been a commentator on MSNBC, CNN, NPR, and more.